tv National Institutes of Health Director on Science Research CSPAN August 25, 2018 12:09am-1:49am EDT
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>> the senate committee on >> in the senate committee on health, education labor and pensions will come to order. senator bennett will have an opening statement and i will introduce the witness, national institute of health director francis collins. we will hear from dr. collins and senators will each have five minutes to ask questions. we have a vote at 10:30 a.m., not in the committee but on the floor, so we will continue straight through with questioning, senator bennett and i and other senators will share the presiding today so we can continue the discussion. not long ago i ran into a friend from vanderbilt university who was perhaps our largest contributor to cancer research. he said, "isn't it a shame that congress isn't doing anything to fund biomedical research?" this is how i replied. i said, "in december 2016,
congress passed what senator mcconnell called the most important legislation of the year, the 21st century cures act and that gave the national institutes of health $4.8 billion for the precision medicine initiative, the cancer moonshot, regenerative medicine as well as new flexibility and authorities to conduct research we hope will lead to breathtaking new medicines, treatments and cures." that was thanks to senator blunt, senator murray, senator moran and many other senators. the appropriations committee is on track to provide record funding for the fourth year in a row to the national institute of health. first congress increased nih funding by $2 billion in 2015, in addition to the cures money. we increased by more than $2 billion again. then in 2017, congress increased funding by $3 billion including
$500 million to work on a nonaddictive painkiller. today, we expect the senate to approve additional $2 billion increase to nih funding for the next year. this means that if the bill we hope the senate approves today is signed into law, congress will have increased funding for the national institutes of health by billion since 2015, 30% increase. the way we do our budgets -- that usually builds into the budgets over a longer time. that money is a base. if you counted over 10 years, $2 new spending authority. these increases have included the funding we intended to deliver on cures. the purpose of this hearing is to make sure that money is being spent wisely. the reason congress has devoted
so much funding to biomedical research is well captured in testimony that dr. collins gave before the appropriations committee a couple years ago. he offered 10 bold predictions, as you called them then, of what we might be able to achieve in the next 10 years if we continue to invest and research as we have. some of these predictions that you made then were -- being able to identify alzheimer's before symptoms appear, the possibility we could rebuild a patient's heart with their own cells, the creation of a safe and artificial pancreas, making life easier for patients with diabetes, new vaccines for nad hiv-aids and the universal flu, the development of nonaddictive pain medicines, which may be the holy grail to dealing with the opioid crisis.
significant progress on the precision medicine initiative, which aims to map the genomes of one million volunteers so we can better tailor treatments to individual and new treatments for cancer patients. those are the bold predictions. the things i hope we keep in mind when we look at these large increases in funding that congress has given the national institutes of health in recent years. first, it is hard to think of a major scientific advancement since world war ii that has not been supported by federal research funding. we are not the only country that has figured that out. other countries have seen that investments in basic research can lead to breathtaking new discoveries. since 2007, china has increased spending on basic science by a factor of four and may surpass the united states in total spending on research and development this year, according
to norm augustine, who during the george w. bush administration chaired the rising above the gathering storm group, the bipartisan committee that was charged with making recommendations about how to keep america's competitive advantage. second thing i hope we keep in mind is that these large increases in funding for biomedical research and other increases for national laboratories and other basic research are not the part of the federal budget that creates a huge national deficit. the suspending we are talking about here is part of the so-called discretionary spending, which is now roughly 29% of all federal spending. it includes national defense, national parks, national laboratories, national institutes of health, among other things. over the last 10 years, this is the part of the budget that has grown at the rate of inflation. over the next 10 years, according to the congressional budget office, is expected to
grow at only a little more than the rate of inflation. funding for research has been carved out of these budget limitations and is not the reason for the increasing federal debt. what causes the federal debt to increase is spending on entitlements, which according to the cbo will squeeze funding for research, national labs and national security over the next 10 years. one other topic, dr. collins, i want to give you an opportunity to discuss. you recently told senator murray and me about an ongoing investigation into federally funded research, including in some cases, research conducted by foreign nationals. i would ask you to take a few extra minutes in your opening presentation to brief the committee on this issue. it is important to protect the integrity of research funded by the federal government. it is also important to recognize the role scientists from other countries have played in research funded by the u.s.
government. for example, the director of the oak ridge national laboratory came to this country from india before he became a citizen. incoming director of the los angeles laboratory came from canada before he became a citizen. director of the national renewable laboratory came from germany, before he became a citizen. many graduate students at american universities who work on nih grants are foreign nationals legally in our country. since 2000, 33 americans who were born in other countries have won nobel prizes in chemistry, medicine physics. i want to a knowledge the great advantage to our country of attracting the brightest people from around the world to our universities and laboratories as long as they follow the rules, and conduct research in appropriate ways. this is an issue that impacts more than just the national
institutes of health, more than just this committee's jurisdiction but if there are bad actors who are attempting to influence nih funded research, we want to know about it and we want to know what authority you need or others need to deal with it. thank you. senator bennett. senator bennett: thank you chairman alexander for holding this bipartisan hearing on nih 's important work, including the agency's progress in implementing the 21st century cures act. dr. collins, thank you for being here today and for your colleagues, thank you for giving us an update. in the last few updates we have seen exponential advancements in medical research. the research community has developed cures and maintenance treatment for serious illnesses that used to be a death sentence. when i worked on the breakthrough senators -- the breakthrough therapies act with we hads burr and hatch,
no idea how successful the program would be. as of august 13, the fda has approved 116 breakthrough therapy designated products. many of which showed the promise of precision medicine. nih supported research has made clear, therapies that target specific genes or molecular pathways make it possible for providers to predict whether patients will respond to certain treatments. this committee recently worked to pass the race for children bill to ensure kids with cancer have the same access to targeted treatment that adults do. pediatric oncologist at children's hospital of colorado are hopeful they can launch 25 new clinical trials because of the law. these treatments will come from the research bench to the bedside in large part because of the great work at nih today. the 21st century cures act included monumental policies to advance medical research. the hope of personalized
medicine has already been a reality for some patients. i am looking forward to hearing about the precision medicine initiative and how we can reach more americans with therapies that maximize benefits and minimize toxic side effects. the 21st century cures act included the brain initiative, which will help researchers in the medical community grasp intricacies of the human brain. though we gained a better understanding of how to treat different types of cancers, cystic fibrosis, the development of meaningful therapies for neurological diseases like alzheimer's, parkinson's and als have lagged behind. i look forward to hearing about the progress on these initiatives. i am also interested to hear more about the work nih's doing to combat the opioid crisis, which continues to rip apart families and take lives in colorado and across the country. this committee has been active in working on an approach as a first step to responding but there is so much more to do. with over 42,000 lives lost in
2016, a preliminary estimate of almost 50,000 americans in 2017, we still have much more to do. i want to thank the chairman for raising the role of talent programs and i'm interested in hearing on what you have to say on the subject. i would like to echo what the chairman stated. breakthroughs in medical research cannot happen with one country, but we want to ensure we prioritize transparency and appropriately deal with bad actors who are taking steps that undermine the science and american efforts to do research. thanks to the chairman and ranking member and dr. collins for being here today. i look forward to your testimony. >> i am pleased to welcome dr. collins. thanks to him for being here. he is overseeing the work of the largest importer of biomedical research in the world. he has been director of nih since 2009. he is accompanied by the
director of the national institute of child health and human development. the director of the national institute of allergy and infectious disease. the director of the national institute on aging. and the director of the national cancer institute. we welcome dr. collins. please give your testimony now. >> senator alexander and senator bennett and members, thank you for giving the extra time to speak on this issue of protecting the integrity of u.s. biomedical research from under foreign influence. nih is built on the bedrock principles of scientific excellence, unassailable integrity, and fair competition. nih's commitment to these principles is unwavering. we have long understood that the robustness of the enterprises is under constant threat by risks to the security of intellectual property and the integrity of peer review. this knowledge has shaped our
existing policies and practices. through our own investigations, conversations with law enforcement and even just from watching the press, we can see that the magnitude of risk is increasing. yesterday, i wrote to the senior representatives of more than 10,000 nih grantee institutions to request a review records for evidence of malfeasance in three areas of concern. failure by some researchers at nih funded institutions to disclose substantial contributions of resources from other organizations, including foreign governments, which threatens to distort decisions about the appropriate use of nih funds. second, the version of intellectual property. in grant applications, to other entities, including other countries. third, failure by some here reviewers to keep information on grant applications confidential,
including some disclosure to foreign entities or other attempts to influence funding decisions. while we at nih depend on the major security agencies and the department of health and human services broader national security efforts to protect our interest, nih and the research community at large have a vested interest in mitigating these unacceptable breaches of trust that could undermine the integrity of u.s. biomedical research. to help address the challenge, i am announcing the new working group of my advisory committee to the director, whose charge will be to identify robust methods to first, improve reporting of all sources of research support, financial interest and affiliations. second, mitigate risk of intellectual property security. third, explore additional steps. protect the integrity of peer-reviewed. fourth and most of our link, to carry out these actions in a way that reflects the traditional partnership between nih and
grantee institutions and emphasizes the compelling values of ongoing honorable participation by foreign nationals in the american scientific enterprise, which you both already highlighted in your meeting statements. president roy wilson of wayne state university and my principal deputy will cochair this group. the other members include, the president of vanderbilt university, the president of the university of washington, president michael drake of ohio state university, president of the university of maryland, president of stony brook university and vice president for research at m.i.t. the u.s. biomedical research enterprise is the envy of the world for the excellence of our discovery and innovation. our leadership is made possible because the overwhelming majority of researchers participating on nih grants are honest, hard-working contributors to the advancement of knowledge that benefits us
all. we must move effectively to root out examples where the system is being exploited but make sure to preserve the vibrancy of the diverse workforce that has claimed -- played a major role in the american biomedical research success story. just like in sports, it takes more than defense to win at science. it takes a strong and talented offense. i would like to focus on the 21st century cures act and other proactive ways you and your colleagues are helping to bolster nih's tradition of success. i spend a lot of time with early-stage researchers. wherever i go, i set aside time to hear from them about dreams, ideas and concerns. i know that you have met many of them both in your home states and on your much appreciated visits to nih. i think it is critical we ask
ourselves, what are doing to foster this next generation of discovery? what can we do to help the nation remain the world leader in biomedical innovation? i believe the answers could lie in five keys to success in science today. they are a stable trajectory of support, a vibrant workforce, computational power, new technologies and facilities, and most of all, scientific inspiration. mr. chairman, you have outlined in what has happened in the last three years and perhaps the fourth about to happen. early-stage researchers are now seeing stable trajectory of support, which provides such an encouragement to tackle difficult, high-risk projects. your work over the last three years is helping us to begin to reverse a distressing decade-long decline in nih 's purchasing power for research, which is carried out in every state of the nation. this year we expect that the end
of fiscal year 2018 to fund more than 11,000 new and competing grants, the largest in history. the 21st century cures with $20 billion over 10 years is a critical part. the second key to success is a vibrant workforce. success cannot lie simply in boosting the number of grants made, it must also increase the number of creative minds receiving those grants. have a look at a new metric we are using to evaluate success. this shows the trend in the number of individual principal investigators supported by nih over the past 15 years. as you can see, that number is once again growing nicely. note the surge that occurs around 2016, a surge that reflects when congress began to change the trajectory of nih the third key to success is computational power.
this probably would not have been on my short list in 2009 when i started as director. like so much else, biomedical research has been transformed by recent explosions in computing power and the big data generated. the brain initiative, for example, which you supported, has created new imaging tools that are turning out droves of data. there is data generated by structural biology, the micro biome, the precision medicine initiative, supported by the cures act. on may 6, we began enrolling one million people living in the united states. today we will hit the 100,000 mark for volunteers. nearly half of those are from communities historically underrepresented in research, providing great opportunities to look at health disparities. to realize the potential of these resources we must develop new technologies at facilities. quite often it is the technology itself that is driving the need
for equally innovative facilities. the new cell-based treatments, immunotherapy. many involve removing cells from a patient's body, engineering them and returning them. many labs are not set up to handle these processes so it is crucial we make upgrades. onto my favorite. scientific inspiration. nih funded researchers come to work every day full of ideas and the wherewithal to see them through, thanks to congress. let me share one example that fits with the theme of this hearing, prioritizing cures. more than a decade ago, nih launched a special project on spinal muscular atrophy. a tragic inherited disease. in its most severe form, it leaves babies unable to hold their heads up, feed well and even to breathe.
nearly all are deceased by 15 months. 10 years ago, there was no treatment. researchers had just discovered the dna mutations that caused it. nih supported more research, working closely with advocacy and industry. one of the most exciting outcomes is from the children's hospital in columbus, ohio which recently tested gene therapy in 15 infants with severe disease. these are infants not expected to survive more than 15 months. the infused a viral vector designed to deliver the normal gene to the spinal cord and held their breath. over the next few months, something truly dramatic happened. like evelyn, who you see in this picture, 100% of the kids who got the highest dose of gene therapy were alive at 20 months. nearly all could talk and feed.
some, like evelyn not only could dok and walk, she can even push-ups. check out this video. [video clip] >> did you get that? i love that! >> do i do push-ups? i am not good at it. >> [laughter] director collins: i'm very happy that evelyn, her mom and dad are here with us this morning. please stand up if you would and say hello. [applause] you think you could do a twirl? i saw one earlier that looked good. maybe a little too many witnesses. [laughter] yeah? maybe if mom would do it. [laughter]
ok. [laughter] does that not warm your heart? in closing, i am proud to lead nih at this time of unprecedented scientific opportunity and strong congressional support. the resources you have adjusted will be used to bring hope to untold numbers of patients and families. we are the national institutes of health but for many, we are the national institutes of hope. thank you and we look forward to questions. chairman alexander: we will begin a round of five minute questions. we have a vote in a few minutes but we will continue through that and pass around the presiding responsibility. first, evelyn, thank you so much for coming. it is a wonderful story. that is the reason we are so interested in the work that dr. collins and his associates do
and thanks to dr. collins' team for being here. let me ask you to talk more about some areas you mentioned but with all this new money -- and it is a lot -- 30% increase in a short amount of time -- the three areas in my conversations with researchers around the country -- they suggest we could do a better job of, maybe you already are and we do not know about it. let me tell you about them. number one. support more young scientists. you talked about that there. the feeling is, if whatever money -- even a lot -- is available only to the established figures, that it discourages the brightest of the youngest scientists, who often do some of their best work of their lives in their early years. we have included that in our
legislation that we passed. you made a focus of it. i would like to know about the progress you are making and what else you intend to do about making sure that a lot of this money is focused on young scientists? number two. the peer review panels. some have said that they are not as high quality as they once were. i do not know if that is true. the suggestion was made that anyone who receives nih grants, there are a lot -- i think he said 10,000? director collins: 11,000. chairman alexander: they have to go into the jury pool and be eligible to be selected. they may not be the best but be eligible to be selected for the panels. the quality of the review panels would be my second question. the third question would be -- i have heard criticism that the proposals have become more conservative and more
bureaucratic and longer and that at one time, proposals before the review panels were shorter and more succinct and bolder. what are you doing about these three things? director collins: those are three wonderful questions and i am glad to respond. they resonate with things we are doing at nih. with regard to young scientists -- totally agree. this is critical, this is the future. we have gone from 2003 to 2015 in a tough time for the young scientists. nih purchasing power dropped way back and likelihood of getting funded got to the point where many of them were quite discouraged. we have benefited from congressional enthusiasm for nih over the last three years and that has helped. we have prioritized the young investigators, early-stage investigators, to be the ones we most want to be sure we are taking care of when they come forward with a new and wonderful idea.
this year, in a program of next-generation research initiative, which is part of 21st century cures, we expect to fund the largest number of early-stage investigators ever -- 1100 of them who have never gotten a grant previously. we have a vigorous group, including graduate students and post ops who are giving us additional ideas on how to encourage those early-stage folks and they will make recommendations to me in december and i will add additional ideas about programs we can do. we want to be sure people not only see us as a place where they can bring ideas but they can bring bold ideas. we want to encourage that. i will come back to the second question. the third question about conservatism in terms of applications and science we fund -- i worry about that. we have been experimenting quite successfully in programs like the pioneer awards, which do not expect a lot of preliminary data
and are quite brief in the nature of the application. they propose something around breaking. -- groundbreaking. with that program in place for 10 years, dollar for dollar, it pays off better than traditional programs and many institutes are adopting a similar program. the general medical sciences institute has moved almost all portfolio into that kind of program, which is a different model and we think is productive. finally, i would say with regard to peer review. we agree that anyone willing should be able to serve on review, and we discovered there were exceptions if you years ago. as of 2015, if you are asked to serve, you are expected to say yes. the numbers i looked at over the past couple weeks, those receiving funding from nih, 80% are serving in that role. that includes younger folks, who may be the older emeritus folks
do not recognize as the familiar faces they thought they would see on a panel, but we need them to be there. chairman alexander: thank you , senator bennett. senator bennett: i remember you sitting at this very table some years ago talking about the cost of the unpredictability of the funding that nih was getting at the time and the difficulty of being able to recruit and sustain academic research if the funding was uncertain. can you tell us today with more certain funding, what difference that is making on the ground in these research institutions around the country? director collins: it has made an enormous difference. that difficult period from 2003 to 2015 made it hard for investigators to be confident they could tackle a program that would take several years to bear fruit. it made it hard for nih, as
project managers and visionaries trying to design something bold, could really be confident that would happen. the 21st century cures was a wonderful antidote to that, providing trajectory for funding for the signature projects over 10 years. we have almost never had that kind of confidence in the future. that bill made that possible. for the average investigator working in the laboratory, to see the way in which this stability has come into the circumstance as opposed to upson -- ups and downs has given them. i talked to a lot of them everyday -- the confidence they are in the right place and doing the right thing and it is ok to tackle something that will not get solved in one year. the way in which this is happening is such a different landscape now, then the world's worst moment, which was sequestration in march, 2013, we lost $1 billion in one very bad day. that ripples through the community. i think we are getting to
recovery. i am sorry to say, we're still at the time where if you are sending a grant to nih, your likelihood of getting funded is only 20%. that is a lot better than it was. we're looking forward to see ways to see that rise. senator bennett: i think that is a testament to the bipartisan support of the committee when we are not getting much of that in the united states congress, that demonstrates you can get some things done. director collins: we are deeply grateful. senator bennett: we are grateful to you. i sent a letter to you about whether there is a consensus in the scientific community on whether our society is becoming addicted to technology and what the health effects are about social networking. last week there was a study showing that, in recent years, 20% of u.s. teens reported reading a book for pleasure while more than 80% said they use social media everyday.
they reported in 2017 found that children 18 years old and older spent 40 minutes a day on devices. 42% of kids eight year old and younger have their own tablets, a major increase from 7% in 2013. it seems to me we need to prioritize research in these areas and i wonder -- thank you for your response to the letter -- but what is nih doing to address these issues? director collins: there is a program funded by nih called abcd, the adolescent brain and cognitive development program. this is tracking 10 and 11-year-old, tracking development, including social media access, brain images, drug access, that will be very useful in this regard. let me ask the child health
institute, they recently held an important workshop. >> thank you for your question. there are issues on early childhood development and the issue of technology addiction later on and how it affects adolescents. nichd recently held a workshop examining psychiatric issues on technology and early brain development. we are concerned about language development. reading comprehension and child -parent interactions. we are very interested in your legislation. senator bennett: thank you very much. chairman alexander: the vote has started so i will vote. senator bennett, if you would chair the committee, i will be back and we can swap the gavel.
senator isakson: i want to add a comment. my first engagement with you was at the national prayer breakfast when you demonstrated your gifted talent of playing classical music on the guitar, which to this day was still one of the best performances i ever saw. i knew then you are special and your success with the human genome and all you have done at nih, i want to commend you. i have parkinson's and have been diagnosed for six years. evelyn and her family has a challenge. i will tell you about a challenge in our family in a minute. because you are the national hope, there are a lot of people today that have hope. you are changing attitudes in the institution of medicines and for patients. i want to thank you for having such a positive solution based favorable attitude toward research, cures and the process that nothing is impossible if we work at it.
you do a great job. director collins: thank you very much. senator isakson: my daughter's best friend is a resident of colorado. and her baby was born with a disease that is totally incurable which terminates life around the age of 10 or 12. it is a degenerative disease. she is now at boston children's hospital undergoing special treatment that has been designed by doctors who have hope of using gene therapy as a way to transmit -- i am out of my league -- i am a real estate salesman. >> [laughter] senator isakson: i do not know about the human genome but they are using that gene therapy to get the treatment to the place it needs to be. they are showing amazing success.
you referred to gene therapy. would you talk about it? director collins: i would love to. thank you for your comments. that was most generous. my colleagues make this job for me the most amazing experience everyday. it is a disease that is a tragic neurological condition that is caused by genetic misspellings. it is amenable to the idea of gene therapy but to turn that into practice has been decades long and it is very exciting to see this is starting to work in certain instances. you saw an example with evelyn, a disorder that affects her, affects the spinal cord and for a long time we thought that would be the hardest place you could possibly imagine getting your gene therapy to be delivered but you have seen what has happened, with this amazing experience, for all of us to see how this is working. you need to get the delivery into the brain and spinal cord in the protocol you're talking about, the delivery is into the
spinal fluid, then to the brain providing that delivery. i do not know the precise status of that protocol. i was gratified to see similar circumstances about huntington's disease. here is one of those incredibly troubling inherited conditions. woody guthrie, one of my heroes, had it. in the last few months, again with gene therapy in place in the spinal fluid, there is clear evidence they are able to reduce toxic proteins and encouraging evidence that it is slowing or stopping progression of disease. that was one of the ones i thought might be the longest to ever yield secrets because of being affected in the brain this way but we're starting to see that. none of that happened without many, many years of hard-fought progress and a lot of disappointments. now i think gene therapy is coming into its own. senator isakson: i agree and it is showing great promise, which i hope we will see one day, just like evelyn. evelyn, thank you for coming.
my kids always get shy, just like evelyn. one last thing to talk about is what you talked about in the brain institute. the stimulation in the brain is now being done to treat parkinson's and other neurological diseases and making remarkable improvements. the more we can continue to invest in that, the more we will invest in not cures, for ways to deal with the ramifications of neurological disease. i want to thank my colleagues on the committee who helped me working on the neurological disease registry expansion under the 21st century cures bill to expand research. thank you for being here. director collins: we appreciate that and the brain initiative, one of the early results will be having a better wiring diagram of the brain so deep brain stimulation, which works and we are not sure why, we will be able to do it much more precisely.
>> thank you senator isakson. senator kaine. senator kaine: i want to thank you. i especially want to thank you dr. collins, you highlighted a great virginia family when you talked about evelyn. evelyn is from centerville? happy to have you here and to get the story that has made such an advancement. it highlights the importance of pediatric specific research. i came onto the committee and i probably had an assumption that research into adult conditions could be scaled to pediatric conditions and so often they are very different. in 2014, i was proud to support the kids at first research act. which increased funding for kids with pediatric diseases by taking a separate, nonhealth related source of funding and putting it into pediatric research.
since that bill passed, it has directed about $55 million, $60 million into pediatric conditions. there has also been improvements made for promoting such research in the 21st century cures act to include the pediatric research study network. what promise does increasing research and clinical trials in pediatric diseases or cancer hold for finding cures or diseases like sma or the childhood cancer that killed gabriela miller when she was 11? director collins: i appreciate the question. we are deeply committed to advancing the cause. one of us happens to be a pediatrician. i will ask her to address the points you have raised about the gabriella miller first research act. >> thank you for your question. always appreciate a focus on children.
nih funds $4.2 billion on pediatric research. research in pediatrics is done in virtually all institutes. we are all working together to make the best use of those $4.2 billion. we fulfilled the mandate of the recent pediatric research network part that was in the cures act legislation by having four predominant networks. idea states, pediatric clinical trials network, which is focused on testing rugs in children, the children, drugs in the neonatal research network and the rare disease network, looking at over 200 conditions. those networks are addressing
many, if not most conditions. we have had successes in that area. i understand you knew her? senator kaine: i did not but i know her parents, who are a great loudoun county family. >> wonderful family. >> the gabriella miller network really creates an infrastructure so that researchers can collect large cohorts of biomaterials from children with conditions such as cancer and congenital anomalies. the infrastructure allows us to work at a very large scale, already has had successes. we have a childhood cancer data set that is publicly available, for pediatric sarcoma. congenital heart disease, cleft palates and hernia. researchers anywhere around the world can make use of that information. senator kaine: you gave me an inspiring answer when you are
before this committee a year ago. i used the analogy of president kennedy saying we could be on the moon by the end of the decade, which seemed to many like science fiction but it was doable and we did it -- can we as a society make a pledge to be addiction free by 2030 and get there? you said we could and we know enough about addiction that as long as we appropriately define what it is, we should make such a commitment. it was not a question about science or understanding. there was an issue of will and resources. i have continued to discuss that as i have traveled around the commonwealth. talk to me if you can -- i am at the end of my time -- i will submit for the record, you did address it in your testimony, i would love to know some of the things you are doing at nih to help us grapple with this problem. just last week, statistics came out, 72,000 americans died of overdoses in 2017.
that is more than the number of americans that died in the vietnam war. we are losing a war every year to despair and despond and see -- despond and see and your agency has a critical role in helping us figure out how to win that war. i will last that question in the record. director collins: i would be happy to respond. we are invested in this and the congress gave us $500 million in the current fiscal year in additional funds to focus on the opioid crisis and we are engaged and moving quickly. senator kaine: thank you, mr. chair. senator bennett: senator cassidy. senator cassidy: thank you for being here. you probably know from previous lines of questioning, i am concerned about priority in spending. a couple background things. you see that there is roughly 1/5 of disability, adjusted with
my colleagues who may not be familiar, just an amalgamation, how much do we lose in terms of productivity with an element of death or sickness? here is mortality from 2015, the funding levels from 2016. we see at societal cost, there is a correlation between how much it costs society, and the disability and death rate it causes. i have figures for obesity. one is how the cdc says this is the folks who died. this is everybody for whom obesity is lifted on the coroner's report, knowing that obesity leads to another conditions that may be a cause of death. can you hold that the other? my continued concern, senator collins -- to the side and do not block the camera because the camera will want to see their
pretty faces -- hold it up higher -- higher -- here you see nih funding. we see, hiv, obviously a lot for hiv, there is diabetes. societal cost. although we spend a lot on diabetes, it is not as much. i am struck -- what i want to emphasize is obesity. this scale cannot do justice to how much it costs society, relative to funding. there is nih funding by disease, $965 million, even though it cost us $190 billion. again, it costs society, $190 billion but we are spending $965 million. this represents how much money
we are spending on it. can you hold that the racial disparity issue. as some of you may know, i worked in a public hospital in louisiana with the uninsured for 35 years and there is a racial difference in obesity. if you look at race, any mention of obesity on a death certificate, much higher rate of obesity for african-americans, american indian or alaskan native, there are clear racial disparities associated with obesity. my question is, can you hold up that other one? the other. is it just a function of how we appropriate money. it seems that obesity is underfunded relative to societal cost. $190 billion societal cost, $965 million in contrast for other diseases, with far more nih
funding. director collins: senator, it is nice to have another iteration of a conversation we had. i appreciate your perspective on obesity, which i totally agree, is an enormous public health challenge for the nation. >> obesity is implicated in alzheimer's, heart disease, cancer. that may not be primary but it is the match that starts the fire for a lot of other diseases. dr. collins: your point is taken. the question, we you have seen how we play this out in the strategic plan to articulate how we set priorities, is this balance between public health need and scientific opportunity. with obesity, we would all agree the problem is a multifactorial one. there are many aspects that
relate to things that nih probably can't control in terms of diet, lifestyle, even the built environment and so on. we are studying those things intensively. in terms of interventions, to do something about this epidemic -- which is fairly recent -- it does not look as if a medical therapy is on the edge of happening. it is a different circumstance then say hiv-aids where we have a clear -- >> in all due respect, in the past you have told me, we do not fund that because we are not on the cusp of great advances. i speak to the director without mentioning your name, and oh, you've got to be kidding, we have so much opportunity. that was repeated several times. obesity researchers might start speaking about all this stuff that quickly passes my level of
knowledge but it seems to be self-fulfilling, that if you say, we will not fund it because we are not ready to go to prime time in research, you never go to prime time and research because you never have the requisite funding. director collins: we are ready to go to primetime on research with obesity. where are the scientific opportunities? you mentioned the micro biome. that is certainly a very powerful one. clearly in terms of things play out, some of that research might not actually score as obesity. that might score as diabetes project or nutrition project. some of it is the bookkeeping part. i take your point. i think this is something we worry about everyday when we meet as institute directors. are we setting the priorities properly? your input has been very helpful. >> i would suggest that we begin to focus more on obesity, which seems to be an outlier.
i now defer. >> senator warren. senator warren: the national institutes of health funds the countries top researchers and doctors, nih grants, medical breakthroughs, universities pursue cutting-edge science. i want to talk about money. i understand. nih needs money. the vast majority of nih funding comes from taxpayers. in 1990, congress established the foundation for the national institutes of health, a nonprofit foundation that solicits private donations to support nih research. that means that if a drug company or device company or big tech company or a lobbying firm wants to fund nih research, they can do so by donating to the nih foundation. dr. collins, according to the most recent list of donors, the top six largest contributors to
the foundation of nih are all drug companies. each of these companies has donated to the foundation every year for at least the past 15 years. do you agree science should be setting the agenda at nih and not donors? director collins: absolutely. senator warren: i understand that is how it is supposed to work. nih comes up with a plan based on science and the foundation gets donations to fund it. when you have your hand up for cash, it is sometimes possible that these lines get blurred. nih recently canceled a study of the health effects of alcohol consumption following an internal investigation that revealed that the alcohol industry was not only funding the study but that the study had been set up to deliver results the industry wanted. this is not the only case this year that has raised ethical questions.
in april, you pulled the plug on a plan to take hundreds of millions of dollars from drug companies that make opioids, some of which are under investigation for causing the opioid crisis in the first place, and using that money to fund a study to treat addiction. if these donations from industry are raising so many ethical questions, why should nih accept them at all? director collins: we are thinking a lot about this in the wake of the examples you cited. as nih director of the last nine years, i can cite you examples where this kind of partnership with industry has made science move faster than it otherwise would have. taken the accelerating medicines partnership. a project which involves pharmaceutical companies working on diabetes, alzheimer's, rheumatoid arthritis, adding parkinson's disease recently.
in those instances, this is all competitive research. data is accessible. it brings around the table scientists from public and private sectors who designed the research building on the strengths of both groups. it advances the causes of science more rapidly than might otherwise happen. there are no strings attached to the money provided by the drug companies, basically that goes to the foundation for nih. it is used to support this program that is totally public about what we're doing. i would defend that has been a good thing. what we need to be careful about -- which has caused us to stub our toe -- which is the source of the funds has a vested interest in the outcome of the study. we have started a cancer him no therapy -- we funded a cancer study, involving industry input trying to identify biomarkers whether immunotherapy will work. everyone wants to know the answer and no one has a stake in
what the answer will be, only that we need the answer. this is a good example of how to work together. we have to be thoughtful about what the design looks like. senator warren: i appreciate that and i'm glad you are working to address the ethical landmines in this area. i think nih should be getting more funding. i will be blunt. if drug companies and rich donors want to chip in for more nih research, they should do it through taxes, like everyone else. i would be happy to write the bill to bump up the contributions. here is the bigger issue -- forcing an agency today to beg for contributions to money to carry out its essential mission, is a glossy invitation for corruption. i believe it is time to end the influence of corporate money in washington and that means calling it out and shutting it down in whatever form. thank you very much, i appreciate the work you are
doing. >> thank you. as luck would have it, i not only get to be chairman for a brief time, but i am up next. [laughter] director collins: perfect. >> dr. collins, always great to see you. i continue to claim you as my cousin and i hope you will not disabuse others. director collins: i am honored. >> the 21st century cures act divided multiyear funding, researchers are working with a team from jackson lab in maine and the main medical center research institute in an nih led effort in kidney regeneration.
some others may want to comment. to address the high health care costs associated with treating chronic kidney disease. i visited the maine medical center research institute and it is absolutely fascinating, the work that is going on. could you tell us whether you are seeing any results yet from the regenerative medicine initiative? i know it is early. director collins: i would love to talk about that and appreciate that this was included in 21st century cures as one of the initiatives with a callout for extra funding. the idea of being able to build whole organs from stem cells is one of the things that has really electrified a law of the community. you could call this tissue engineering. what is happening with hearts and kidneys is particularly of
interest. i had thought to put it in my briefcase today, i could have brought you a kidney on a chip that has been made by a different group but is very much working with the people in maine . the idea that we could figure out the appropriate kind of signals to send a stem cell might have been derived from your skin and convince it that it should become your next kidney seems like science fiction, maybe not so much. so far these are small renditions but i have seen some of these that have a bit of a blood circulation and could even make a little bit of urine. so, we are on the path here. ultimately, we hope that this could become an alternative for the need for a transplant for somebody who's kidneys have failed. we learned a lot about normal kidney biology that could maybe keep people's kidneys from failing. your group in maine is a very important one in this effort, and i am glad to have been by to see it.
sen. collins: it truly is miraculous work they are doing and it is so excited to me. as you're well aware, dr. collins, i have been the founder and cochair of the senate diabetes caucus and alzheimer's disease task force for many, many years. as our population is growing older, we are seeing increased incidences of both those diseases. there is also intriguing science that suggests that there may be a link between the two diseases, as well as cardiovascular disease. could you tell us what kinds of findings you are seeing in that area and what promising research is underway? director collins: that is a great question. i will ask our international expert on alzheimer's and he also knows a lot about diabetes. >> thank you for the question. there has been extensive collaboration for those interested in diabetes and those the generative diseases such as alzheimer's.
it has taken several forms. it has been known for some time for example, that diabetes is a risk factor for alzheimer's disease. there have been metabolic parallels and similarities between diabetes and what goes on in the brain, in fact, some would call alzheimer's disease a type three diabetes. there is a clinical trial ongoing using an intranasal route for introducing insulins selectively to the brain, to look for its impact on the progression of alzheimer's and cognitive decline. at the basic science level and now, translated interview -- into real clinical trials. we are much aware of the commonalities that have to borrow and disciplines to best accomplish our goals. sen. collins: thank you very much. >> thank you very much, madam chair. good morning to this
distinguished panel. thank you for being here and the work you do. as you know, the fentanyl, heroin, and opioid epidemic is ravaging my state of the hampshire and communities across the country. i was very proud to work with the delegation to secure a significant increase in funds for the granite state to use in treatment and recovery, for substance abuse and mental health services. now, new hampshire is receiving $23 million for 2018, before that it was $3 million. so, we think that we have the potential to really have an impact on the ground. i think it is very important that we stay focused on making sure that the hardest hit states or the states with the highest mortality rates, get the concentration of funds that they need. but we also need to make sure we are supporting science here, because we need more and better
ways to treat addiction and manage pain. it is a critical part of curbing the opioid crisis, and i appreciate the conversations we have had about it. i also very much appreciate the work that the nih is doing on initiative. when you were before this committee last, you explained that you need and more flexibility to fund research more quickly and efficiently. since that time, i have been really pleased to work with chairman alexander, ranking , and senator young to introduce the cutting edge research act to give the nih the flexibility it needs to quickly advance research, by providing the transactional authority that we talked about. so, how will the other transaction of authority provided by the act help the nih to work on the opioid epidemic? director collins: i appreciate the question and your support. let me explain why it would be
so useful, and why the timing is kind of urgent right now. the heel initiative, we want to identify three places in the nation and bring together in a way that has not happened before all other players in that. we are trying to bring together in a way that hasn't happened before as the research enterprise, all the players, the primary care docs, the emergency care docs, the criminal justice system, all the other support systems -- the state at health department, to see what we can do if everybody works together in a coordinated way to tackle this problem. because no single one of those will be successful in ending this terrible national crisis. to be able to do this, which has never been attempted before, having the flexibility where we can reach out and identify partners who have never written an nih grant and say, we want you, and also have an active role in nih managing this effort
in with grants, which we sometimes cannot do, we would go faster and more effectively. we will try and do this anyway. if we had transaction authority, it would make a big difference in our ability to carry out the heel initiative. sen. hassan: i hope the senate will act soon on this. i want to go to one other new hampshire issue if i may. one that has implications all across the country. families in my state have questions about what contamination in drinking water, means for their health and the health of their children. once used for a variety of commercial and industrial applications, pifa has seeped into water tables in many places. there is a critical need to understand and address any adverse health effects.
dr. collins, what is the nih doing to study these chemical compounds and their potential health effects and americans? director collins: this is a significant environmental concern. i know in new hampshire there has been a discussion about it. michigan is caught up in this. particularly around kalamazoo. this is the kind of substance that has a long half-life and is not naturally occurring, but has found its way into water supplies because of manufacturing of things such as carpet cleaners and so forth. in terms of the environmental risks, we really don't know enough about the human risks to be very confident in saying whether this is a big deal, or whether actually, humans are able to handle it. we do know that it could have immune consequences including perhaps even cancer, but there is a big project which dod is funding, which the national institute of environmental
services is part of, and i think this will provide the kind of data that we currently don't have, at least in terms of epidemiology, of what is the relation to the exposure and the human medical problems. we desperately need more information of that sort. sen. hassan: i thank you for allowing me to go over. allow me to pinpoint any gaps in research that you are my feet, and i appreciate again, all of your work. sen. collins: senator smith. sen. smith: thank you madam chair and thank you all of you for being here today. it is an interesting panel. we are coming and going from votes. if i have a moment i would like to follow up on the questions that senator hassan started. i want to start out by saying i believe in the power of innovation and biomedical research, coming from my home state of minnesota, which is such a center of excellence, both in the university of minnesota, and also the mayo
clinic. senator collins was talking about the power of regenerative medicine which is something we have been working on intensely, especially at the mayo clinic. i believe strongly in that. i also believe, if people cannot afford the therapies and the medicines that we are imagining, that we are creating, we have a real problem. i have to tell you that this is the number one issue i hear about from minnesotans, whether it is figuring out how to pay for a therapy like insulin, which has been around for 100 years, to figuring out how to pay for the most recent cancer breakthrough medicines, it is a huge problem. a lot of these therapies have of course, been created because of help from the nih. i am told that everyone of the 210 new drugs approved by the
fda between 2010 and 2016, nih contributed to. what happens, of course, is that the cost of innovation is often the reason why medicines cost so much. yet in some ways, i think, taxpayers feel like they are paying twice. once for the support from the nih, and again, when they are forced to pay these exorbitantly priced medicines when they show up in the pharmacy. tell me a little bit about how you see the role of the nih in helping to make sure that we do not only have innovation, but also innovation that people can afford? director collins: obviously, this is a source you are echoing of discussion and much concern. views about how this kind of drug pricing issue will be wrestled to the ground. we at nih, you have quoted this
recent study published in the national academy of sciences, where colleagues looked across a five or six year a road and said, every single one of the fda approved drugs were based on basic science discoveries that nih had supported. some of those were basically to discover, here is a drug, target, and than a company went out and said, let us go and find a target. sen. smith: there is a difference between commercialization and basic research, i understand. director collins: you could say the ecosystem in the united states, between basic science, much of it supported by the nih, and commercial application, has been the reason we have been so successful, but the prices, are certainly a concern. we do not have a lot of levers to pull indirect influence as to -- in terms of influence as to how prices are set, what we do and will we can do more of now, because science is going forward, is to make it possible for the successes to happen more
often. one of the reasons drugs is so expensive is because the failure rate for a company trying to get a drug across the finish line, is 99%. when you finally get something that works, you have all of that stuff that you spent money on that got you nothing, that has to be accounted for. at the national center for advancing translational sciences, part of the nih, we are identifying the sources of the high failure rate systematically and coming up with new technologies that make that less likely to happen. if the success rate was 5%, is -- instead of 1%, it would make a huge difference in the financial circumstances. we are pushing as hard as we can on that command that is probably our best contribution. sen. smith: i think it is an important issue to work on together. basic access to these incredible therapies that are being created, is fundamental to whether our health care system works at all, and for those of us who watch this and try to understand it, but we also see
how these big companies are making a ton of money. yet we are all paying -- that is i think, the fundamental issue that i am grappling with, and trying to find solutions to. because innovation is so important, and affordable drugs are so important, i would like to be it will to work together on that. mr. chair i am out of time, but i would like to submit to the record, and for follow-up, a question having to do with what senator hassan was talking about. in minnesota, we call it diseases of despair. there has been a significant uptick, 40% increase in suicide and other diseases related to behavioral health and opioids and addiction, what we can do and how we can work with nih on that. thank you.
sen. jones: thank you dr. collins and the whole team for being here and for the incredible work you do. i really appreciate that. a couple of weeks ago i had the privilege of meeting with some of the leaders at university of alabama at birmingham, which i consider also to be one of the leading institutions of not only higher learning, but also research, in the country. not only have i met with them at the company is the cancer institute, but i also had a chance to talk about your precision medicine program. i know that everyone is excited about the "all of us" research program, because precision medicine truly has the potential for being a game changer, for providing the right treatment to the right person at the right time. i am so happy that alabama is playing a role. dr. collins, i just have a general question. what is it that congress can do other than to continuously trying to fund levels and is
there something specifically that we, as members of congress can do to promote the use of precision medicine? director collins: i appreciate you raising this issue and mentioning the program. in response to your what can we do? it may be useful for congress to become an ally with nih and encouraging people to take place in this unprecedented national experiment. we are asking one million people to sign up. we hit 100,000 today. we have a ways to go, but it is a wonderful start. i appreciate how uab is a part of this partnership in the south. we can have people sign up by direct volunteer, where they basically get online and join
allofus.org and sign up, or if they are nearby to one of the health provider organizations, to partner with us and get their care there, they consent up with us in that fashion. we are hoping this to move quite quickly. this is taking what we have learned from a program like this one that has taught us so much about cardiovascular disease and extrapolating it by a factor of 40 in terms of the size, covering all diseases. everybody sitting at the table has a stake. we will enroll children starting next year. senator jones: i can tell you, even before you said that, one of the things i discussed with them at uab, that my wife and i will go and will try to make an event of that, signing up. and i will encourage all my colleagues to do the same. let me move on to one other question that i had, because you touched on this earlier. in response to your question,
the question about developing the next generation of talented biomedical researchers. which is an extraordinary effort, and i applaud the effort. one of the things i am concerned about is trying to reach into underserved communities. it seems that we are missing such talent that is out there, whether they are researchers or doctors or lawyers. what can we do as part of the programs that we have got now, to specifically reach into underserved areas, to grab that talent out and give them that extra motivation they need, because they do not always have the chances like kids in areas that have a lot more money? director collins: i appreciate that point, because this is an area of great concern. nih has been trying to increase the participation in our research workforce and we have not been that successful in
terms of making this happen. our workforce is still underrepresented when it comes to african-americans, latinos , and native americans. but, we have a couple of new programs that are now underway for about three or four years, that are starting to show promise. one thing is to recognize that a lot of that tablet does not necessarily end up in a research-intensive four-year college environment. but has an interest in getting involved in that research. the thing that makes that interest turn into reality is getting involved in a research project itself, not on the getting to know more about it but actually doing the research yourself. the program called build is a partnership between universities that have a lot of underrepresented groups in their student bodies, but do not have the research opportunities that would really benefit, and they partner up with institutions that do have those research capabilities, to give those talented folks a chance to see what it is like. the other thing missing is mentoring. if you do not see anybody like
you who is a role model, it is a lot harder when he hit a bump, to imagine that this is your future. so, we set up a whole mentoring research network to connect people. if you do not have somebody down the hall from you, maybe there is someone in your town, your state or someone over the phone who has lived the life you are trying to live. that seems to be a big encouragement. we are evaluating this. and seeing real progress. >> i will have a couple more questions about infant mortality and maternal mortality, which is something that is going underreported. thank you, mr. chairman. something that is going underreported today. thank you mr. chairman. >> thank you. senator bennett. >> i had a couple of remaining questions. dr. collins, after we passed 21st century cures we worked on and were able to pass the race
for children act as part of the fda user fee package. i know that nci has been collaborating with the fda to create cancer drugs for children, when treatments are effective for adults, and it may be effective for children. some of those treatments could be immunotherapy's come or even treatments that are successful in treating cancer. and i understand that some of these therapies have been successful in treating certain pediatric cancers, yet other approaches have not been as effective. i wonder if you can talk about what nci is doing to ensure that children will benefit from advanced immunotherapy? >> thank you, it is an exciting area.
as you alluded, there is a lot of progress going on. because of the structure of mutualization, there is not a lot of encouragement. the race act was to encourage companies to develop it for years. i think it is a sharp way to do it. it does not hurt innovation, but it provides a real emphasis on childhood cancer, which was an area we had seen a lot of progress, but we still need a lot more. so, the race act directed the nci to develop a list of relevant targets, and the list is now developed through a series of meetings between the nci and the fda. published online, it is seven pages, and if you are making a drug to this target,
you have to have a plan to test test it on kids. we eagerly await to see how this is implemented. we believe that pharmaceutical companies will comply with this law. sen. bennet: finally, i appreciate the update you provided on precision medicine initiative. particularly with respect to all of the research campaign that you are talking about, saying that it will give research a lot more data to predict prevention and treatment needs. as we begin to think about the future of medicine, i just wanted to know whether you think nih needs additional authority to keep up with the fast pace of science. researchers in colorado have been at the forefront of some of these biomedical advances, there are more than 720 companies in overate employing coloradans through direct or 160,000 indirect jobs, most of which a extremely well. when we think about the hope of personalized medicine and the level of innovation we are seeing, what is the best way to
follow up on 21st century cures? director collins: i think what the 21st century cures bill provided, over a very thoughtful to years of selecting and hearing from a various stakeholders, about what would be most useful, was that it did incorporate a number of legislative authority that we greatly value. there was a question from senator hanson about this other authority, being able to use that in our common fund has made a lot of difference in the ability to move quickly. we would actually be grateful to have even broader authority for and othersaction rapid, it is perhaps more moving, maybe people think that it is a little more riskier, but in certain instances, it has made all the difference.
so, that would be an area. if we have theat opportunity to expand our authorities -- if we got to a place where we actually have the opportunity to do an assessment on a strategy that is not particularly interesting to the private sector, the ability to carry out out phase three trials would be of value at the present time. that is not something that we have you 30 to do, that is just another example of something that could help us. but again, i cannot say enough about the way that 21st century cures basically took a list of the things that we wanted to be able to do, and pretty much check to the boxes, one by one, and made it able for us to move quickly. sen. bennet: i cannot resist asking one more question before i go. what are you worried about? these days? [laughter] >> thank you for the question, senator. as you probably would have guessed, i always worry about the emergence of an infectious
disease, like the prototype of pandemic influenza, or a respiratory disease that spreads rapidly and has a high degree of mortality. it is for that reason that my colleagues and i have been working on, for the last, at least a decade, but more intensely, over the last couple of years, on the development of a universal influenza vaccine that would not only be important the need to get a vaccine every single season, and try to guess, hopefully correctly, what the next season's flu is going to be able to immunize children at a very early age, like we do with me souls slumps and rubella, to be it to protect them from the possibility of an unexpected catastrophic outbreak what we saw on the pandemics that was we experienced. as a matter of fact, we recently
had a meeting with individuals throughout the country and around the world, to be in with to help us formulate a strategic land to develop a research agenda for the development of universal flu vaccine. you can ask dr. collins and i, many people asked when it was going to happen, we know have phase two and phase three clinical. trials that look very promising just literally in the next day or so, there will be an announcement from the university of pennsylvania of a very, very interesting approach to a vaccine, that involves recombinant dna technologies that will be very, very important. i have for your staff, if they want it, a paper that we just recently published in the general of infectious diseases, which outlines strategic plans for the universal flu vaccine, and/or research agenda. so, that is what i worry about, but we are trying to do
something that i worry about. [laughter] sen. alexander: thank you dr. collins and to each of you for your extraordinary service to our country. that was one of dr. collins' bold predictions and it is good to hear that it is on the way. , a universal vaccine. it is good news. we are glad to see a significant , new and consistent source of funding directed tour the nih, but we want to make sure that we spend every single dollar as wisely and effectively as possible. we hope this hearing and other tools that we give you, either through 21st century cures or the authority to use money in different ways, you will let us know what you need. we have a lot of -- senator bennett has been a leader in many of these bills, a lot of bipartisan support for breakthrough initiatives, and we want to create an impairment
where you can succeed. the hearing will remain open for 10 days, members may submit additional information for the record within that time, if they like. the health committee will meet again on wednesday, august 29 when we hear from dr. scott gottlieb, commissioner of the food and drug administration. thank you for being here. the committee will stand adjourned.
>> the interviewer is someone doesn't know a lot about medical a few minutes into it, it was clear that this was not the usual circumstances. i decided to just play it safe. it's a very interesting conversation. >> did you consider cutting that our short? >> i certainly did. maybe there's a public health message that could be wrapped in here. and there was. things . reporter: i know there has been a controversy at duke, regarding a specific nih incident, any catalyst about that discussion? there has been a specific
incidents that we are exploring cover we sent a letter to the institution saying that we are concerned about the investigator in your faculty. reporter: more specifically. >> yes, we have evidence of somebody who has an nih grant and is getting a lot of money from a foreign government, that should have been included in the grant application, and we're asking them to look into it. reporter: how short is that list? >> it is about a half-dozen. nih have anys resource besides taking away the funding? >> it doesn't really fit into the conduct that is narrowly defined as major resume, but it is a different kind of bad behavior, so we would not go come of it can go to
the inspector general if we find evidence that somebody is conducting themselves in a fashion that is illegal. so we have various tools that we can bring to that. right now, it is a lot of fact-finding. some of these groups, i do that, and i should have told you, i forgot, in which case, don't do it again, but we are concerned about circumstances where people may have the intention of being said to have come up with the intention of diverting intellectual property, or perhaps use their access to year review and shipped overseas. reporter: there was a note in the broader letter about getting to the fbi field office. is there guidance that they can provide? right, theabsolutely fbi has been looking at this set of issues, and some of what they know, you can only hear about if you are within the classified , it is stillerial under classification. onus are you much
institutionhe it for failing to see it? >> our situation is, we do not grants to the scientist, we give grants to the institution. so we say to the institution, hey, you better look at this, it is your responsibility. these letters that we sent out yesterday, all of them are intended to send a signal. inhink fairly recently, biomedical research, people hadn't thought of this as an thought of it in out o defense, but clearly, there is a lot going on in biomedical research as well. the chinese are intentionally trying to gain expertise in biomedicine, which has led to some of these circumstances, with people that they have been supporting who have also been involved in their version of
intellectual property. reporter: what is the penalty for a scientist found to be dissipating in that? >> it can be anything from losing your ability to have your grant, to being debarred from ever getting a grant, and if it is actual criminal activity, there is potential of somebody bringing a charge, depending on the severity of the infection. reporter: can you tell us anything about the types of research these scientists were working on? >> technology in some particular also,f interest, potential missed chief, because of the intellectual property consideration. reporter: the convergence you are talking about earlier with technology and medicine, you mentioned the risk of that increasing now. is that increasing? >> maybe events, and it could be that there is more funding being put into this by foreign governments, particularly one, just as they have found us to be a very attractive way to build
>> a look ahead at the senate. andeports for the hill alex, the senate not taking the normal august recess. not sending senators back home to their states to campaign. why are they staying in session? what are they planning on working on in the week ahead? >> they stayed in session to get more of trump's judicial nominees confirmed and to make more progress on the appropriations bills. trump, when he signed the on the year,ackage earlier this that increased federal spending $300 billion for the next two years.